large intestine, but occasionally occur in the small intestine in
cases of uræmia. Typhoid ulcers usually have their longest diameter
parallel with the longitudinal axis of the intestine; tuberculous
and carcinomatous ulcers usually encircle the intestine, forming
“ring ulcers;” diphtheritic and dysenteric ulcers are irregular,
involving the surfaces of the folds. Solitary round or peptic ulcers
occur in the duodenum and jejunum. Decubital ulcers, associated
with fécal concretions, gall-stones or foreign-bodies are found in
appendix and rectum most commonly, more rarely in other portions of
the intestines. _Perforations_ of the intestines may be traumatic, or
due to infections (typhoid, tuberculous, purulent, dysenteric, etc.),
neoplasms (carcinoma), embolic gangrene, ileus, fécal impaction,
erosion of calculus or foreign-body, parasites (round-worm?),
over-distention, etc.
The most important pathologic conditions of the intestines are:
anomalies (atresia, diverticulum, stenosis, dilatation, hernia),
acute and chronic passive congestion, hæmorrhage, stasis, embolism
and thrombosis, hæmorrhagic infarction, gangrene, traumatic
injuries, ileus, volvulus, strangulated hernia, enteritis
(catarrhal, follicular, hyperplastica, cystica, purulent, ulcerative,
croupous, diphtheritic, dysentery, cholera, typhoid, etc.),
appendicitis (catarrhal, ulcerative, perforative, obliterative),
tuberculosis, syphilis (chiefly in rectum, ulcers, stenosis and
perforations), actinomycosis, anthrax, intestinal sand, concretions,
foreign-bodies, and neoplasms (primary carcinoma the most
important [adenocarcinoma, colloid, scirrhous, medullary, etc.],
most frequent in large intestine and rectum, secondary carcinoma
is rare; adenomatous polypi are common, particularly in rectum;
primary sarcomata [lymphosarcoma chiefly] are much less common than
carcinoma, secondary sarcoma more common than primary [melanotic
sarcoma, lymphosarcoma]. Benign connective-tissue tumors [lipoma,
fibroma and myoma] are relatively rare. Primary carcinoma and sarcoma
occur in the appendix, as well as secondary carcinoma). Leukæmic
infiltration is common in leukæmia.
4. =Bile-passages.= Note patency, character of mouth, contents,
etc. The most important conditions are inflammation, gall-stones,
obstruction, stenosis, dilatation, perforation, carcinoma, and
anomalies (in the new-born). Round-worms may obtain entrance and
block the duct.
Public-domain text, read in full here on John Shaqi.
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